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NLM Tool, RxMix, Provides New Insights into Questionable Use of Psychiatric Drugs

RxMix, a digital tool developed by the Lister Hill National Center for Biomedical Communications at NLM, was one of the keys used in an investigative report to unlock concerns about the use of psychiatric drugs in juvenile correctional facilities in Pennsylvania.

A multi-part story by PublicSource, a Pennsylvania-based news organization, found that young adults sent to correctional facilities in the commonwealth “receive mood-altering psychiatric medications at strikingly high rates, particularly antipsychotic drugs that expose them to significant health risks.”

The report, which was published throughout Pennsylvania, stated that “over a seven-year period, enough antipsychotics were ordered to treat one-third of the confined youth, on average, at any given time.”

Pennsylvania Department of Human Services said in the story that the department “provides individualized health care to the juveniles with a multidisciplinary team that regularly monitors the effects of psychiatric medications, also called psychotropics. The protocols we have in place actually lead to a reduction or termination of medication when possible.”

PublicSource used RxMix to standardize drug names and to classify the drugs dispensed by type of medication (antipsychotic, antacid, anti-inflammatory, etc.). PublicSource also performed additional data quality checks after running the data through the RxMix tool. All of this is acknowledged on the website that hosts the report.

“PublicSource contacted us in January 2015 to see if they could use the RxNorm application programming interface (API) to facilitate the analysis of medications prescribed to juveniles. RxMix was the best option for them as it required no programming to map lists of drug names or codes to RxNorm,” said Dr. Olivier Bodenreider, a senior scientist at the NLM Lister Hill National Center for Biomedical Communications.

RxMix, RxNorm and the other drug information sources developed by NLM support health information exchange and processing. These resources are heavily used for healthcare and research purposes. Over the past year alone, NLM has received 1 billion queries to these APIs from hospitals, academic centers, health insurance companies and pharmacy benefit managers, as well as through mobile applications.

This particular use of RxNorm, however, was different.

“It is the first time RxMix was used to support investigative journalism. It came to us as a surprise, but we are glad we could support PublicSource in their mission. Analyzing prescriptions in terms of pharmacologic classes was key to the important findings in this report,” Dr. Bodenreider noted.